PATRICK LOUIS JACKSON

PLAQUEMINE, LA
NPI1427273713
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy332B00000X Durable Medical Equipment & Medical Supplies
(Licence: LA  332B00000X)
Enumeration Date2007-04-13
Last Update Date2007-07-08
Business Address
Mr. PATRICK LOUIS JACKSON
58110 W W HARLEAUX ST
PLAQUEMINE, LA 70764-3230
Phone number: 225-385-4251
Mailing Address
Mr. PATRICK LOUIS JACKSON
58110 W W HARLEAUX ST P.O . BOX -986
PLAQUEMINE, LA 70764-3230
Phone number: 225-385-4251